Ageing Flashcards
Name the 2 theories of ageing
Programmed Ageing
Damage/ Error Theory
Outline the Programmed Ageing theory of ageing
Cells have limited number of times they can divide due to genetic programming
Outline the Damage/ Error theory of ageing
Mitochondrial generation of NO/ H2O2 free radicals damages mitochondira –> decreased respiration reactions –> cell death
What is the stringest evidence for the Damage/ Error theory of ageing?
Ageing process accelerated in both smokers and those with inflammatory conditions
What is the main reason for the ageing population?
Advances in public health that have prevented INFECTION SPREAD
Recall 3 challenges faced by society on account of having an ageing population
- Retirement/ pension is longer
- Caring for older people
- Extending HEALTHY age
Define “frailty”
Loss of biological reserve across multiple organ systems, leading to vulnerability to physiological decompensation and functional decline after a stressor event
What % of >85s are frail?
33-45%
Recall 5 non-specific presentations of frailty
- Falls
- Weight loss
- Confusion
- Recurrent infection
- Less “textbook” features of disease
What are the 3 main spheres of difficulty in managing disease in older people?
Multimorbidity
Polypharmacy
Iatrogenic harm
Recall 2 reasons for polypharmacy in the elderly
- Undetected non-adherence
2. Infrequent review of meds
What is inappropriate polypharmacy associated with increased risk of?
Falls
Delirium
Give 3 examples of iatrogenic harm that the frail/ elderly are particularly vulnerable to
- Giving bad drug combo eg amlodipine with frusemide
- ADRs
- Deconditioning
Which drugs are most likely to cause ADRs?
NSAIDs
Give 3 reasons that the elderly are at a particularly high risk of ADRs
- Impaired physiological reserve
- Impaired compensation mechanisms
- Comorbidities
What is a CGA?
Comprehensive Geriatric Assessment:
- MULTIdisciplinary
- Produces proble list and plan
Recall 3 normal changes in the ageing brain
- Very slight slowing in processing speed
- Reduction in divided (but not simple) attention
- Reduction in executive function
Recall the key definitive features of dementia
Decline in ALL cognitive functions that is progressive, degenerative and irreversible
How does dementia differ from delirium?
Unlike dementia, delirium is acute, fluctuates and alters conscious level
What is the most useful form of cognitive assesment?
Montreal Cognitive Assessment
What is assessed by the MCA?
Visuospatial funciton, naming, memory and attention
Recall 4 advantages of the MCA
Covers a variety of domains
Brief
Available in translated versions
Widely-used
Recall 4 disadvantages of the MCA
Affected by education level
Floor and ceiling effects
Can be poorly-administered
May have coaching/ practise effects
Recall 3 general limitations of cognitive assesment tests
Affected by:
Hearing/ visual impairments
Assumption of numeracy and literacy
Acute illness
Which cognitive test can be used diagnostically?
Addenbrooke’s Cognitive Examination
